NPIMap

Organization Active NPI

Everest Long Term Care, LLC

  • Skilled Nursing Facility
  • Clayton, NC
National Provider Identifier
1003205337
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
EVEREST LONG TERM CARE, LLC
Practice address
195 Springbrook Ave
Clayton, NC 27520-8105
Phone
(919) 550-7200
Fax
(919) 550-7299
NPI assigned
Jan 9, 2015
Organization subpart
Yes
Parent organization
PRINCIPLE LONG TERM CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Karen G McDaniel
Title
President/Ceo
Phone
(252) 523-9094

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

195 Springbrook Ave
Clayton, NC 27520-8105

Mailing address

195 Springbrook Ave
Clayton, NC 27520-8105
Phone (919) 550-7200

Other names 1

  • Springbrook Nursing and Rehabilitation Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150707001824 NC Part A Provider - Skilled Nursing Facility 0749464154 Practice locations: Clayton, NC

Skilled nursing facility certification: CCN 345569

Legal name
EVEREST LONG TERM CARE, LLC
Doing business as
SPRINGBROOK NURSING AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 2015
Last certification
Apr 24, 2025
Beds
100
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Principle LTC
Organization structure
LLCProprietary
Incorporated
Aug 16, 2010 in NC
Enrollment address
195 Springbrook Ave
Clayton, NC 27520-8105
Nursing home name
SPRINGBROOK NURSING AND REHABILITATION CENTER
Affiliated entity
PRINCIPLE LONG TERM CARE

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Springbrook Nursing and Rehabilitation CenterCCN 345569
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 1, 2015
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10095.0 residents per day on average
Chain
Principle Long Term Care40 facilities in the chain
Penalties (3 years)
3Fines totaling $25,625

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2093806Springbrook Nursing & Rehabilitation195 Springbrook Avenue, Clayton, NC 27520Certificate of waiverApr 5, 2027

National Provider Directory

National Provider Directory
Tax ID family
Ability Network3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Networks

  • SC HMO

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Raymond Gregg Hill Individual 5% Or Greater Direct Ownership InterestOwner/Board Member Jun 2, 2015 18.47%
Adp of the SNF Jun 2, 2015
Direct Ownership Interest Jun 2, 2015 18.47%
Robert O'Neil Hill Individual 5% Or Greater Indirect Ownership InterestOwner Jun 2, 2015 20.6%
Adp of the SNF Jan 1, 2011
Direct Ownership Interest Jan 1, 2011 20.6%
Tami Kendall Individual Managing Control - Governing BodyAdministrator Nov 18, 2020
Adp of the SNF Jun 19, 2025
John F Lue Individual Managing Control - Governing BodyMedical Director Feb 16, 2017
Adp of the SNF Feb 16, 2017
Stephen Britt Hill Individual 5% Or Greater Direct Ownership InterestOwner/Board Member Jun 2, 2015 20.02%
Adp of the SNF Jun 2, 2015
Direct Ownership Interest Jun 2, 2015 20.02%
Gale R Boice Individual Corporate OfficerCfo Mar 5, 2018
Operational/Managerial Control Mar 18, 2018
Adp of the SNF Mar 5, 2018
Dianne Johnson Individual Corporate OfficerTreasurer Jun 2, 2015
Principle Long Term Care, Inc. Organization, Kinston, NC For-profit 5% Or Greater Direct Ownership Interest May 1, 2015 50%
Operational/Managerial Control May 1, 2015 50%
Principle It Services, Inc. Organization, Kinston, NC For-profit 5% Or Greater Direct Ownership Interest May 1, 2015 50%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 43

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 43

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1003205337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 SPRINGBROOK AVE",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275208105",
            "telephone_number": "919-550-7200",
            "fax_number": "919-550-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 SPRINGBROOK AVE",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275208105",
            "telephone_number": "919-550-7200",
            "fax_number": "919-550-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVEREST LONG TERM CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRINCIPLE LONG TERM CARE, INC.",
        "enumeration_date": "2015-01-09",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "252-523-9094",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Springbrook Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Springbrook Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clayton, NC

Sources for this page

Verify at the official NPI Registry.